Drugs & Aging最新文献

{"title":"Correction: Anticholinergic Exposure, Drug Dose and Postoperative Delirium: Comparison of Dose-Related and Non-Dose-Related Anticholinergic Burden Scores in a Retrospective Cohort Study of Older Orthopaedic and Trauma Surgery Patients.","authors":"Carolin Geßele, Constanze Rémi, Vera Smolka, Konstantinos Dimitriadis, Ute Amann, Thomas Saller, Dorothea Strobach","doi":"10.1007/s40266-024-01173-2","DOIUrl":"https://doi.org/10.1007/s40266-024-01173-2","url":null,"abstract":"","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Prescriptions for Low Back Pain among Military-Connected Older Adults Across Multiple Care Systems.","authors":"Janiece L Taylor, Patricia K Carreño, Shannon Alsobrooks, Alexander G Velosky, Germaine F Herrera, Maxwell Amoako, Megan O'Connell, Ryan C Costantino, Krista B Highland","doi":"10.1007/s40266-024-01176-z","DOIUrl":"https://doi.org/10.1007/s40266-024-01176-z","url":null,"abstract":"<p><strong>Background: </strong>Untreated low back pain (LBP) in older adults can lead to disability and development of chronicity. Due to the potential development of medical comorbidities and negative risks associated with pharmacological use, chronic LBP management for older adults requires a responsive approach.</p><p><strong>Methods: </strong>The objective of this study is to evaluate the probability of (1) opioid prescription receipt and (2) opioid-sedative coprescription, in a sample of military-service-connected patients enrolled in the Veterans Health Administration (VHA) or TRICARE, ages 30-85 years, receiving care in three systems: VHA, Military Health System (MHS), and nonfederal (civilian) healthcare facilities. Generalized linear models evaluated inequities across intersections of age, race and ethnicity, and care system.</p><p><strong>Results: </strong>Age was negatively associated with opioid-sedative coprescription receipt (p < 0.001) but was not significantly associated with opioid prescription receipt (p = 0.09). Across both models, Asian and Pacific Islander, Black, and Latine patients were less likely than white patients to receive either outcome (p < 0.001-0.002). Opioid-sedative coprescription probability decreased across age for Asian and Pacific Islander (p = 0.003) and Latine (p = 0.01) patients in the MHS but increased in white patients.</p><p><strong>Conclusions: </strong>It is imperative that clinicians and healthcare systems provide effective and sustainable treatment for LBP in older adults, including programming, that enhances shared decision-making and whole-health approach championed by the VHA.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Centric Approach for the Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease in Older People.","authors":"Kevin T Mueller, Alene A Saavedra, Lauren A O'Keeffe, Jeffrey A Sparks","doi":"10.1007/s40266-024-01175-0","DOIUrl":"https://doi.org/10.1007/s40266-024-01175-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to outline considerations for treating older adults with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) as it relates to infection, comorbidities, cancer, and quality of life.</p><p><strong>Recent findings: </strong>The recent 2023 American College of Rheumatology/American College of Chest Physicians guideline conditionally recommended specific disease-modifying antirheumatic drugs (DMARDs), antifibrotics, and short-term glucocorticoids to treat RA-ILD. Since RA-ILD often affects older adults, we contextualize these pharmacologic options related to infection, gastrointestinal (GI) effects, cancer, cardiovascular disease, and quality of life. Nearly all DMARDs and glucocorticoids are immunosuppressive and increase infection risk. Rituximab, mycophenolate, cyclophosphamide, and glucocorticoids may have particularly high infection risk. Many therapies recommended for treating RA-ILD have potential GI side effects. Antifibrotics have a high rate of nausea and diarrhea. Janus kinase inhibitors may increase risk of cancer and cardiovascular disease in older people. In older individuals, decisions must weigh the risks and benefits of drug options while considering clinical and social factors such as polypharmacy, adherence, cost, convenience, and social support. Management of RA-ILD in older individuals is complex and should consider risks and benefits, while optimizing quality and quantity of life through a shared decision-making process.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis in Older Men: Informing Patient Management and Improving Health-Related Outcomes.","authors":"Carmelinda Ruggiero, Carla Caffarelli, Valeria Calsolaro, Laura Tafaro, Francesca Riuzzi, Valentina Bubba, Nicola Napoli, Marika Ferracci, Patrizia Mecocci, Andrea Giusti, Giuseppe Rinonapoli","doi":"10.1007/s40266-024-01163-4","DOIUrl":"https://doi.org/10.1007/s40266-024-01163-4","url":null,"abstract":"<p><p>Osteoporosis has been usually considered a female disease, generally causing more fracture risk and complications in adult and older women compared to older men. While vertebral fractures occur in a small proportion of men during middle age, men generally fracture about 10 years later than women, with significant increases in fracture risk after about age 75. Independent of age, men experiencing fragility fractures have a higher risk of life-threatening events compared to women, but the risk of secondary fragility fracture overlaps between men and women. Often, male osteoporosis recognizes the overlap between secondary causes and primary osteoporosis risk factors. Assessment through physical examination, history, and laboratory tests is recommended, with dual-energy X-ray absorptiometry of bone density being the preferred diagnostic test for osteoporosis in men. A treatment program should include awareness of diet and vitamin D status, fall risk reduction, and pharmaceutical therapy. Medications that are fracture-reducing in older women should also achieve fewer fractures in older men; however, there is a paucity of studies in men with the primary outcome of fracture risk reduction. Most older men with osteoporosis should be treated with oral or intravenous bisphosphonates, denosumab especially when on androgen deprivation therapy, and initial anabolic treatment should be considered for men at very high risk of fracture. This review summarizes the main features of osteoporosis and fragility fractures in men and reports findings from the available pharmacological and non-pharmacological studies conducted in men.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Hyperkalemia Risk in Frail Older Patients Using RAAS Inhibitors.","authors":"Anna M J Heemels, Nadine P P M Gadiot, Angele P M Kerckhoffs, Namiko A Goto","doi":"10.1007/s40266-024-01171-4","DOIUrl":"https://doi.org/10.1007/s40266-024-01171-4","url":null,"abstract":"<p><strong>Purpose: </strong>Renin-angiotensin-aldosterone system inhibitors (RAASi) are widely used in treatment of cardiovascular and renal disease. While effective, they pose a risk of hyperkalemia. In the general population, risk factors for hyperkalemia include chronic kidney disease, congestive heart failure, and use of medication affecting potassium balance. These risk factors are prevalent in frail older patients. Therefore, this study aims to explore the prevalence and risk factors for hyperkalemia associated with RAASi use in this vulnerable population.</p><p><strong>Patients and methods: </strong>This single-center, cross-sectional study included RAASi users aged ≥ 70 years who presented at the emergency department. Clinical Frailty Scale (CFS) according to Rockwood was calculated retrospectively from information in clinical files. All patients with CFS ≥ 5 were considered frail. Hyperkalemia was defined as serum potassium ≥ 5.5 mmol/L at time of presentation at the emergency department. Potential risk factors for hyperkalemia in older patients were identified using logistic regression models.</p><p><strong>Results: </strong>Of the 2023 participants, 86 (4.3%) were hyperkalemic, with no significant difference between frail and non-frail patients (4.7% versus 3.3%, p-value 0.157). Hyperkalemic patients were slightly younger than non-hyperkalemic patients (median age 83 versus 84 years, p-value 0.023), and females were slightly overrepresented in both groups (52.6% and 53.5%, p = 0.867). Risk factors associated with hyperkalemia in older RAASi users included younger age (odds ratio (OR) 0.95, 95% confidence intervals (CI) 0.92-0.99, p = 0.010), diabetes mellitus (OR 1.67, 95% CI 1.05-2.65, p = 0.030), moderate to severe kidney failure (OR 9.87, 95% CI 6.01-16.21, p < 0.001), and use of potassium-binding agents (OR 14.62, 95% CI 1.56-137.40, p = 0.019) and potassium-sparing diuretics (OR 2.66, 95% CI 1.57-4.50, p < 0.001).</p><p><strong>Conclusions: </strong>Contrary to expectations, this study found no association between frailty and hyperkalemia in older RAASi users visiting the emergency department. These results suggest that frail older patients without additional risk factors can be treated with RAASi when indicated, similar to the general population. The main risk factors for hyperkalemia in this population remain consistent with those in the general population, emphasizing the importance of monitoring kidney function and medication use.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza and Aging: Clinical Manifestations, Complications, and Treatment Approaches in Older Adults.","authors":"Christian I Rosero, Stefan Gravenstein, Elie A Saade","doi":"10.1007/s40266-024-01169-y","DOIUrl":"https://doi.org/10.1007/s40266-024-01169-y","url":null,"abstract":"<p><p>Influenza, a highly contagious respiratory viral illness, poses significant global health risks, particularly affecting older and those with chronic health conditions. Influenza viruses, primarily types A and B, are responsible for seasonal human infections and exhibit a propensity for antigenic drift and shift, contributing to seasonal epidemics and pandemics. The severity of influenza varies, but severe cases often lead to pneumonia, acute respiratory distress syndrome, and multiorgan failure. Older adults, especially those over 65 years of age, face increased risks of immune senescence, chronic comorbidities, and decreased vaccine efficacy. Globally, influenza affects millions of people annually, with significant morbidity and mortality among older. Epidemiological patterns vary with climate, and risk factors include age, immunocompromised status, and preexisting chronic conditions. In older adults, influenza frequently results in hospitalization and death, which is exacerbated by immunosenescence and biological organ changes associated with aging. Clinical manifestations range from mild symptoms to severe complications such as viral pneumonia and multiorgan failure. Diagnosis often relies on antigen or molecular tests, with radiological examination aiding in severe cases. Treatment primarily involves antiviral agents, such as oseltamivir and peramivir, with the greatest benefit observed when initiated early. Management of severe cases may require hospitalization and supportive care, including addressing complications, such as secondary bacterial infections and cardiovascular events. This article highlights the need for improved vaccination strategies and novel treatments, including monoclonal antibodies and adoptive T cell therapies, to better manage severe influenza infections in vulnerable populations such as older.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Management of IgG4-Related Disease: From Traditional to Mechanism-Based Targeted Therapies.","authors":"Mitsuhiro Akiyama, Waleed Alshehri, Koichi Saito, Tsutomu Takeuchi, Yuko Kaneko","doi":"10.1007/s40266-024-01172-3","DOIUrl":"https://doi.org/10.1007/s40266-024-01172-3","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is an immune-mediated disorder characterized by organ enlargement and dysfunction. The formation of tertiary lymphoid tissues (TLTs) in affected organs is crucial for understanding IgG4-RD, as T follicular helper (Tfh) 2 cells within TLTs drive IgG4+B cell differentiation, contributing to mass formation. Key cytokines IL-4 and IL-10, produced by Tfh2 cells, are essential for this process. Additionally, cytotoxic T cells and M2 macrophages significantly contribute to inflammation and fibrosis in the lesions. These insights into IgG4-RD have led to the development of innovative targeted therapies. While glucocorticoids are effective in many cases, they often cause disease flares during tapering and rarely result in long-term, treatment-free remissions. Long-term glucocorticoid use poses significant challenges owing to potential side effects, particularly in older patients who may already have complications such as diabetes and atherosclerotic diseases. In contrast, targeted therapies offer a promising alternative, potentially providing more effective disease control with fewer side effects. Current research is exploring several exciting approaches, including B-cell depletion, targeted immunomodulation of B cells, Bruton's tyrosine kinase inhibition, disruption of co-stimulation pathways, targeting the SLAMF7 cytokine or its receptor blockade (BAFF, IL-4, or IL-6), and JAK-STAT signaling pathway inhibition. These emerging strategies hold the promise of improving patient outcomes and advancing the management of IgG4-RD.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Low-Dose Quetiapine for Insomnia in Older Adults.","authors":"Rita L Hui, Ashley L Lee, Eric A Lee, Robin S Lee, Fang Niu","doi":"10.1007/s40266-024-01170-5","DOIUrl":"https://doi.org/10.1007/s40266-024-01170-5","url":null,"abstract":"<p><strong>Background and objective: </strong>Quetiapine is a Food and Drug Administration (FDA) approved second-generation antipsychotic. It is also commonly used at low dose for its sedative properties to treat insomnia in the older population. Quetiapine at standard doses has been associated with increased risk of cerebrovascular events, cognitive decline, and mortality in patients with dementia, especially within older adults. However, there are limited data describing its safety at lower doses, especially for the treatment of insomnia in older adults. This study aims to compare the safety of low-dose quetiapine versus trazodone or mirtazapine for insomnia in older adults in the USA.</p><p><strong>Methods: </strong>This was a retrospective cohort study that included patients aged 65 years or older who started low-dose quetiapine, trazodone, or mirtazapine for the treatment of insomnia from October 2018 to September 2021. The primary outcome was all-cause mortality and secondary outcomes included new incidences of stroke or transient ischemic attack, dementia, and falls with or without traumatic fractures. They were identified from electronic medical records using ICD-10-CM clinical diagnosis codes. Eligible patients were followed from the initiation of the drug until death, end of target drug exposure or escalation of dose, end of health plan membership, or 30 September 30 2022, whichever came first. Patients initiated mirtazapine or trazodone were matched to each patient who initiated quetiapine at a 4:1 ratio using propensity score matching method.</p><p><strong>Results: </strong>We included 375 patients initiated on low-dose quetiapine, who were matched to 1500 patients started on trazodone and 1500 patients started on mirtazapine. Comparing patients who received quetiapine with trazodone, the quetiapine group had an increased risk of mortality (hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.2-8.1; P < 0.05), dementia (HR 8.1, 95% CI 4.1-15.8; P < 0.05), and falls (HR 2.8, 95% CI 1.4-5.3; P < 0.05). When comparing quetiapine with mirtazapine, quetiapine group had an increased risk of dementia (HR 7.1, 95% CI 3.5-14.4; P < 0.05). No significant differences were detected in other outcomes.</p><p><strong>Conclusions: </strong>Caution should be taken in practice when using low-dose quetiapine for insomnia in older adults. It is associated with significantly higher rates of mortality, dementia, and falls when compared with trazodone and a higher dementia rate when compared with mirtazapine.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Medication Complexity and Post-Hospitalization Outcomes in Older Adults Hospitalized for Heart Failure.","authors":"Aayush Visaria, William McDonald, John Mancini, Andrew P Ambrosy, Min Ji Kwak, Ashkan Hashemi, Mark S Lachs, Andrew R Zullo, Monika Safford, Emily B Levitan, Parag Goyal","doi":"10.1007/s40266-024-01166-1","DOIUrl":"https://doi.org/10.1007/s40266-024-01166-1","url":null,"abstract":"<p><strong>Introduction: </strong>Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included Reasons for Geographic and Racial Differences in Stroke (REGARDS) participants aged at least 65 years hospitalized for heart failure between 2003 and 2014. We calculated changes between hospital admission and discharge in medication count (Δcount) and in the validated Medication Regimen Complexity Index (ΔMRCI), which incorporates each medication's dosage formulation, frequency, timing, and special instructions. The primary outcome was a composite of 90-day all-cause readmission and all-cause mortality post-discharge. We calculated ΔMRCI and Δcount, identified their predictors, and examined their association with the primary outcome.</p><p><strong>Results: </strong>Among 725 patients hospitalized for heart failure, the mean (SD) age was 77 (7.2) years, 46% were female, and 35% were Black. At discharge, nearly 75% had an increase in their medication regimen complexity and 60% had an increase in their medication count. Patients with the highest ΔMRCI and Δcount were more likely to be female and Black. Predictors of the highest ΔMRCI included Charlson comorbidity index and not being discharged home; predictors of the highest Δcount included intensive care unit stay. Approximately 48% of patients experienced a 90-day readmission or death. Neither ΔMRCI (highest versus lowest tertile; HR 1.14, 95% CI 0.86, 1.50) nor Δcount (HR 0.97, 95% CI 0.73, 1.27) were associated with 90-day outcomes.</p><p><strong>Conclusion: </strong>Following a heart failure hospitalization, increased medication regimen complexity was common but was not associated with 90-day post-hospitalization outcomes. These are reassuring data, suggesting that it is reasonable for clinicians to focus on optimizing medication regimens for patients with heart failure even if it increases regimen complexity.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Clinical Validation of TIME Criteria to Detect Potentially Inappropriate Medication Use in Older Adults: Methodological Report from the TIME International Study Group.","authors":"Gulistan Bahat, Tugba Erdogan, Busra Can, Serdar Ozkok, Birkan Ilhan, Asli Tufan, Mehmet Akif Karan, Athanase Benetos, Antonio Cherubini, Michael Drey, Doron Garfinkel, Jerzy Gąsowski, Anna Renom-Guiteras, Marina Kotsani, Lisa McCarthy, Graziano Onder, Farhad Pazan, Karolina Piotrowicz, Paula Rochon, Georg Ruppe, Wade Thompson, Eva Topinkova, Nathalie van der Velde, Mirko Petrovic","doi":"10.1007/s40266-024-01164-3","DOIUrl":"https://doi.org/10.1007/s40266-024-01164-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Various explicit screening tools, developed mostly in central Europe and the USA, assist clinicians in optimizing medication use for older adults. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria set, primarily based on the STOPP/START criteria set, is a current explicit tool originally developed for Eastern Europe and subsequently validated for broader use in Central European settings. Reviewed every three months to align with the latest scientific literature, it is one of the most up-to-date tools available. The tool is accessible via a free mobile app and website platforms, ensuring convenience for clinicians and timely integration of updates as needed. Healthcare providers often prefer to use their native language in medical practice, highlighting the need for prescribing tools to be translated and adapted into multiple languages to promote optimal medication practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe the protocol for cross-cultural and language validation of the TIME criteria in various commonly used languages and to outline its protocol for clinical validation across different healthcare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The TIME International Study Group comprised 24 geriatric pharmacotherapy experts from 12 countries. In selecting the framework for the study, we reviewed the steps and outcomes from previous research on cross-cultural adaptations and clinical validations of explicit tools. Assessment tools were selected based on both their validity in accurately addressing the relevant issues and their feasibility for practical implementation. The drafted methodology paper was circulated among the study group members for feedback and revisions leading to a final consensus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The research methodology consists of two phases. Cross-cultural adaptation/language validation phase follows the 8-step approach recommended by World Health Organization. This phase allows regions or countries to make modifications to existing criteria or introduce new adjustments based on local prescribing practices and available medications, as long as these adjustments are supported by current scientific evidence. The second phase involves the clinical validation, where participants will be randomized into two groups. The control group will receive standard care, while the intervention group will have their treatment evaluated by clinicians who will review the TIME criteria and consider its recommendations. A variety of patient outcomes (i.e., number of hospital admissions, quality of life, number of regular medications [including over the counter medications], geriatric syndromes and mortality) in different healthcare settings will be investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The outputs of this methodological report are expected to promote broader adoption of the TIME criteria. Studies building on this work are anticipated to enhance the identificatio","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}